BREAKING CONSCIENCES
IWONA GALINSKA
According to the clause of conscience: ‘A doctor can sustain from doing health services incompatible with his conscience subject to the art. 30, but considering the fact that it is his duty to point to possibilities of gaining this service from another doctor or a therapeutic entity and justify and register this fact in medical documentations. A doctor doing his job on the basis of an employment contract or within his service, he has a duty of informing his superior in writing first’.
This provision, included in the Act about doctor’s jobs and dentist’s jobs (art 39), in practice concerns mainly gynecologists. For many of them abortion, in vitro surgeries, prescriptions for contraceptives are services incompatible with the conscience of a doctor. The clause concerns also midwives but in the opinion of doctors their participation in the surgery is minimal. It is a very hurting attitude. Recently the issue of the midwife Agata Rejman from the hospital Pro-Familia in Rzeszów has become popular, who, having participated in three abortion surgeries, could not do such work any longer. She expressed her objection to a doctor on duty, but the doctor did not react. In the opinion of the director for medical issues, ‘participation of women in this surgery is marginal. It is based on laying a patient on an armchair and giving a doctor literally one tool’. This matter is differently perceived by Agata Rejman: - Before a midwife starts assisting in the surgery, to a doctor’s order she connects a drip of systolic drugs and is observing a patient all the time. It is a very stressful situation because we are aware that administered medications are harmful for an alive pregnancy. Unfortunately, after everything, we are left alone with an aborted baby and we have to place it in a container, and pour formalin on it. After the surgery a doctor leaves and does not care about anything else. Midwives, for fear of the loss of work, hide their feelings inside. Many of them cannot endure it and must look for help in mental health clinics.
Legal shortcomings in the act concerning the clause of conscience were noticed after the attitude of the Bioethics Committee of the Polish Science Academy was expressed in November. It was stated that it was forbidden to impose moral beliefs on others, especially patients. This February the Team of Experts for Bioethics of the Polish Episcopal Conference was defending the clause of conscience, defining clearly that restrictions also concern abortifacient means, contraceptives and referrals for medical examinations preceding abortion.
In the same month the Chief Medical Council submitted a request to the Constitutional Tribunal to examine the compatibility with the constitution of art. 30 of the Act about doctor’s jobs and dentist’s jobs, saying that a doctor cannot refer to the clause of conscience (art. 39) and refuse to help ‘in any case when a delay in help could cause a danger of losing life, severe body injury or a severe health state and in other cases which are urgent’. These words about ‘cases which are urgent’, are incompatible with the constitution. For, a doctor is forced to do service incompatible with conscience when there is an emergency case but it is not a danger for a patient’s life, nor leads to a complete injury of the body or health disorder. The Chief Medical Council thinks that the provision forcing a doctor to suggest his colleague who does the surgery is also unconstitutional. It is the breach of a doctor’s conscience who does not want to do the surgery of pregnancy termination by himself but is forced to suggest where it can be done. Objection is also aroused by the statement that a doctor refusing to do the surgery must inform superiors about it. In the opinion of the Chief Medical Council, a doctor should have a right to not informing about anyone about his worldview beliefs. The Constitutional Tribunal has not issued a statement in this issue yet. Despite visible legal shortcomings, the health minister Bartosz Arlukowicz says that the clause of conscience functions well and there is no need to change it. This is a response to the idea of novelization of the act. This initiative was presented by the senator Kazimierz Jaworski and the Association ‘Hands of life’.
Disputes on the clause of conscience started.
Declaration of faith as the beginning of the conflict
The initiative of signing the Declaration of Faith by doctors and students was suggested by dr. Wanda Poltawska – a friend of John Paul II and the moral authority. The declaration emphasizes the priority of God’s law over the human law. The human body and life, being God’s gifts are holy and intact from the conception to natural death – the text says. It also says about the need of ‘counteracting to the imposed anti-humanitarian ideologies of the modern civilization’. Signatures under the declaration were collected via Internet and during this year’s pilgrimage of health service to Jasna Gora. This act is to be a thanksgiving for canonization of John Paul II. Over three thousand signatures were collected. And leftist groups, mainstream magazines, various the so-called moral authorities started an attack. And a scapegoat was quickly found. Prof. Bogdan Chazan - a gynecologist and obstetrician became the scapegoat, who was popular as a great scientific and moral authority. A round-up started. Recently the health minister Bartosz Arlukowicz has appeared. He informed on Twitter that he was starting the proceeding – for explanation he directed the issue to the Chief Spokesman of Professional Responsibility of the Chief Medical Chamber. The spokesman started the explanatory proceeding. The National Health Fund will control the accuracy of the contract realization, and medical proceeding will be checked by the health minister with the national consultant. If the law infringement is confirmed, a procurator will be informed about it. The government spokesman Malgorzata Kidawa-Blonska stated that prof. Chazan had breached law and he should not manage the state clinic. Leszek Miller gave a verdict that the professor had committed a crime and the Democratic Leftist Alliance informed procurators about it. The National Health Fund, the Townhall of the capital city, the Spokesman of the Patient’s Rights started controlling the Hospital of Holy Family. The spokeswoman Krystyna Kozlowska stated that after the preliminary analysis it is possible to make a conclusion that the patient’s right to information and access to medical documentation might have been breached. Mass media came into the succor of the indignant. The weekly ‘Wprost’ published a text full of emotions about a woman who has been trying to have a baby for the fifth time and in the 22nd week of her pregnancy she finds out about ‘an incurable illness’ of her baby. There are no doubts that her son is going to die after the birth. As a patient of the Hospital of the Holy Family in Warsaw, she asks prof. Chazan for abortion. According to her dramatic report, the professor delays his decision, referring her to other medical examinations. Finally he refuses to do the surgery and does not suggest any other clinic which would carry out the pregnancy termination. Time passed on. The 25th week – it is impossible to do the surgery. The mother must give birth to her baby, although – as she says – she had already said farewell to the baby at the time when she heard the dramatic diagnosis. The text and the talk with unhappy parents are unambiguous. The professor behaved dishonorably, exposing the mother to bear the ill pregnancy. There are words about cruelty, hatred to women, etc. The professor published his statement on Twitter in which he wrote: it is not true that the patient has had a series examinations done and I was artificially prolonging the moment of a diagnosis. I gave her my answer to the patient’s request about abortion on the following day’. He did not refer her to another doctor saying: ‘I think that it would mean participation in the procedure of abortion. Besides, I do not know a doctor who would deal with it. (…). However, a clinic belonging to the hospital employs many doctors whose beliefs have never been the subject of my interest’. A few days later the professor was a guest of Dorota Gawryluk in Polsat News. He was explaining his behavior in a clear and balanced way. He said that he had suggested that woman further conducting pregnancy, care during the labour and after it for both the mother and the child. He also suggested the prenatal hospice. The professor thinks that helping the mother through killing her baby is quite an odd way of help. A woman in such cases acts under shock, and psychical results of her decision about abortion can feel till the end of her life. He also noted that the baby in the 23-24th week feels pain like a new-born baby, and premature babies being born are prone to increased sensation of pain. The surgery in the case of this woman is taking out a baby in pieces. The atmosphere during this ‘shambles’ is like near a scaffold. Only a few people can endure such a view.
It is difficult to believe that any mother in her biggest pain and despair would sentence her child to such a suffering. Indeed, in the name of not shocking the mother with such pictures, this talk did not take a place. And, it is a pity, using any euphemisms will not give a good results in these kinds of cases. Each of us, regardless of our worldview, must face up much suffering in life, which is God’s mystery. One should help the person touched by suffering, not using her tragedy as a prey to witch-hunt against an inconvenient human being. But these are cruel rights in our journalism.
A surprising answer of prof. Chazan was in the program of Krzysztof Zemiec. The woman published her statement in ‘Wprost’ that she was still a patient of the hospital of the Holy Family and she would give birth to her child there. The professor also said that ‘nothing proves the fact that this child may die. Either during the pregnancy or after it’ (…) It is not so bad as media present it’. Prof. Chazan often emphasized the superiority of ethical principles over the statutory law which can be changed. ‘It is difficult to understand – he says – why doctors have been burdened with a duty of killing children (…). Abortion is the execution of death verdict’.
Double morality
The so-called women’s defenders follow a strange logics. They defend humanitarian rules used towards women touched by the tragedy of giving birth to incurably ill children. According to our law such children should not be born. Interestingly enough, these rules are not used in children’s hospices. One can only go there to see incurable ill babies suffering from cancer. Is suffering of their mothers lesser than the trauma of women who decide for termination of pregnancy because their children are suffering from an incurable illness? ‘Women’s defenders’ do not demand killing ill children in the hospice, so why are they fighting for the eugenic selection of children?
It is difficult to understand this medial clamor around the Declaration of Faith, these absurd opinions of people from whom we should expect more seriousness and wisdom. These are also academic teachers bringing up the young generation. Prof. Magdalena Sroda sounds humorous when she accuses prof. Chazan of hatred to women and nationalism, because ‘it is only important that we would multiply ourselves’. Whereas prof. Jan Hartman is mourning over the pressure on doctors doing abortion, accuses the Church of ideological pressure, and defines the Declaration of Faith as ‘miserable, fanatic measure of backwardness’. Indignation is also expressed known publicists. For Tomasz Lis the Declaration of Faith is ‘an invasion of religious bigotry of Lechistan. Iran is emerging from it’. Tomasz Wolek scares us with Poland in which the Declaration of Faith will concern teachers or police officers. It is astonishing why such people direct their hatred to those who are the most defenceless, severely ill unborn children.
And, anyway, isn’t it hypocrisy to give the holy name to hospitals where abortion is committed? Prof. Chazan said that the name of the Hospital of the Holy Family obliges us to something. A patient who wants to have abortion done should know that in the hospital of such a name children are not killed.
(AA)
"Niedziela" 26/2014